Polymorphic markers in the 5alpha-reductase type II gene and the incidence of prostate cancer

In the prostate, the enzyme encoded by the SRD5A2 gene (5alpha-reductase) converts testosterone to dihydrotestosterone, a potent androgen that has been hypothesized to play a role in the genesis of prostate cancer. Several polymorphisms have been identified in the SRD5A2 gene, including a valine-to-leucine substitution (V89L) at codon 89, a variable number of TA dinucleotide repeats and a missense substitution at codon 49 resulting in an amino acid substitution of alanine with threonine (A49T). To investigate the influence of these polymorphisms on prostate cancer risk, we conducted a case-control study nested within the Beta-Carotene and Retinol Efficacy Trial. Genotypes were determined by PCR-based capillary electrophoresis using genomic DNA isolated from 300 cases and 300 controls matched on the basis of race, age at enrollment (within 5 years), enrollment study center and year of randomization. There was no association between V89L genotypes and prostate cancer risk. The age- and race-adjusted odds ratio (OR) associated with the VL and LL genotypes were 1.06 (95% confidence interval (CI) = 0.75-1.49) and 0.99 (95% CI = 0.57-1.73), respectively, as compared to the VV genotype. The age- and race-adjusted odds ratio for men having 1 TA(9) or TA(18) allele was 0.98 (95% CI = 0.64-1.48) when compared to men without TA repeats. The corresponding odds ratio for men without the TA(0) alleles was 0.68 (95% CI = 0.21-2.19). The age- and race-adjusted odds ratio associated with having at least 1 T allele at codon 49 was 1.11 (95% CI = 0.58-2.11), as compared to the AA genotype. Our results do not support the hypothesis that the V89L and A49T polymorphisms in the SRD5A2 gene are related to the risk of prostate cancer, but are compatible with the suggestion from earlier studies that men who are homozygous for the TA(9) or (18) alleles and men who have the TA(9)/TA(18) genotype are at a modestly reduced risk.     

Cultural influences on developmental processes and outcomes: implications for the study of development and psychopathology

The purpose of this paper is to trace the role of culture as an explanatory construct in developmental processes and outcomes, and its implications in the understanding of developmental psychopathology. Literature reviews were conducted by historical period: 1930-1939, 1960-1969, and 1990-1999. The percentage of the total articles and chapters pertaining to cultural issues increased as a function of time. Both conceptual and methodological continuities and discontinuities were observed among the three periods. The preponderance of comparative studies using deficit models still remains, but more enlightened alternative conceptual models, within culture studies, and measures of cultural processes, are emerging. In contrast, although contextual influences are considered important in developmental psychopathology, the field lags in its empirical consideration of cultural influences. The need to seriously address these issues will increase as globalization and rapid cultural change become even more the norm than the exception.     

Production of specific retinal S antigen antibodies in patients with retinal detachment

One hundred patients with retinal detachment (61 primary operations and 39 reoperations) were studied for titers of autoantibodies to human retinal S antigen using the enzyme-linked immunosorbent assay technique (ELISA). There was no statistically significant difference when comparing the group of patients with primary retinal detachment with the control group. However, a statistically significant increase in anti-S titers was recorded when a comparison was made between the group of reoperated patients and the control group (²,P < 0.001) and between the group of reoperated subjects and the group of patients operated on for the first time (²,P < 0.005).Presented at the XVth Meeting of the Club Jules Gonin, Copenhagen, 10–15 August 1986     

The N2N instrument to evaluate healthy work environments: an Italian validation

Objectives

The aims of the study were to (a) validate N2N Healthy Work Environment tool, (b) assess the healthiness of work environments as perceived by nurses themselves and (c) identify the factors associated with Italian nurses’ perception of work environment healthiness.

Methods

The linguistic and cultural adaptation of USA-N2N Healthy Work Environments was achieved through a process of forward/backward translation. Content validity was assessed by three expert nurses. The stability of the instrument was checked with a test/retest evaluation. The instrument psychometric properties, the confirmatory factor analysis as well the healthiness of the work environment and its determinant factors were evaluated with a sample of 294 nurses.

Results

The content and face validity of the N2N Healthy Work Environment instrument was confirmed. The instrument demonstrated good internal consistency (α of 0.82), excellent stability values (ρ > 0.70) and high levels of acceptability (response rate: 96.4 %). The confirmatory factor analysis has corroborated the existence of two factors as documented in the original instrument (Mays et al. in J Nurs Manag 19:18–26, 2011). Eighty-seven (29.6 %) nurses perceived the work environment where they work as “healthy”. Working under a functional model of care delivery (χ² 24.856, p 0.000) and being responsible for one project or more (χ² 5.256, p 0.021) were associated with healthy environments.

Conclusions

The instrument—valid and reliable, short in the number of items, easy to understand and based on international standards—allows a systematic assessment of the healthiness of the environment and might provide not only the opportunity to evaluate the effects of new organizational models and interventions, but also the possibility to activate a process of self-analysis and a process of ongoing review. The instrument can be used to systematically check the healthiness of Italian working environments, allowing for organizational diagnosis, targeted interventions and international comparisons.     

Intentional Seroconversion in the Gay Community: The Social Work Role in Assessment and Intervention

ABSTRACT

There is a reported increase of intentional seroconversion in the United States over the past several years in the gay community (Crossley, 2004 Crossley, M. 2004. Making sense of bare backing: Gay men's narratives on unsafe sex. Resistance Habitus. British Journal of Social Psychology, 43(2): 225–244. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Trinufol, 2003). This article reports on a sample (n = 24) of men who identify their motivations behind their pursuit of seroconversion. Respondents were asked to identify what motivations were connected to their attempt to become seropositive. Three general variables emerged as potential indicators: (1) seeking relief from emotional HIV fatigue, (2) the wish to be closer with one's HIV positive partner, and (3) the expectation to become HIV positive. By identifying these possible motivations (both psychological and sociocultural), sex educators and therapists providing counseling to the gay male community may be better equipped to more effectively identify clients at high risk for intentional seroconversion. Recommendations for assessment and intervention with those at high risk for such behaviors are provided by the authors.     

Continuing medical professional development in Uruguay as the country faces the 21st century]

This paper outlines the evolution of the concept of continuing medical professional development in Uruguay, as that professional development has progressed from independent and varied efforts that were not coordinated or evaluated to a plan that is aimed at improving the quality of educational activities and programs and making them accessible to all the physicians in the country. In contrast to countries where scientific societies and medical associations preside over continuing professional development, in Uruguay the Graduate School of the School of Medicine of the University of the Republic has taken on managing and developing this process. The key objective of this process is for the Graduate School to work in conjunction with other leading players in professional development to create a national system of continuing medical professional development. This system should be interinstitutional and include both public and private entities. By having the key public institutions (the Graduate School and the Ministry of Public Health) working with private entities (medical associations, scientific societies, and health care institutions), there should be an adequate balance of interests. The national professional development system should work in the most decentralized manner possible and should be based on a network of units distributed around the entire country, but with centralized coordination. The system's interinstitutional character should ensure high technical and ethical standards as well as a balance among the governmental, commercial, professional, and university components. This system should serve as the basis for extending this activity to all health personnel in Uruguay. While the national system is still being finalized, the Graduate School has implemented a process of accrediting institutions that are involved in continuing professional medical development. The aim of this accreditation process is to improve the educational offerings for physicians and to generate practical experience that will serve the future system.